Harmony Healthcare International (HHI) Blog

Notice Of Medicare Non-Coverage & SNFABN Non-Coverage Pt.VII

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Doctor using laptop near stethoscope and clipboard in medical officeQuestion and Answer with Sally Fecto Sr. VP Field Operations Harmony Healthcare International (HHI). 

  1. On the ABN form, it has a place to enter information to contact the Medicare contractor. What information is put here and how do I find this information?
I believe you are referring to this section of the SNF ABN:
  • If in 90 days you have not gotten a decision on your claim, contact the Medicare contractor

    at: Address:                                                                                                                
    or at:  Telephone:                                 TTY/TDD:                                                    

The Medicare contractor is the Medicare Administrative Contractor (MAC) 
A Medicare Administrative Contractor (MAC) is a private health care insurer that is awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries. 

The MAC is specific to your region/jurisdiction.  Your biller will have the contact information for your MAC.  The map below shows the various MACs and their area of coverage. 

AB MAC Jurisdictions

  1. Did CMS issue a ruling not to use the NOMNC forms for non-traditional Medicare? Please clarify.

    The rules for the NOMNC and SNF ABN differ: 
    • Many Managed Medicare providers will provide their NOMNC with their specific contact information. The facility may use the generic form in the absence of the Managed provider. 
    • The NOMNC is required for all Medicare A/B and Managed A/B patients to inform and provide an avenue for an expedited appeal. 
    • However, the SNF ABN is only used for traditional fee for service Medicare Part A beneficiaries.
harmonyhelpHarmony Healthcare International (HHI) is available to assist with any questions or concerns that you may have.  You can contact us by clicking here.  Looking to train your staff?  Join us in person at one of our our upcoming Competency/Certification Courses.  Click here to see the dates and locations. 

Topics: Denial Letters

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